Neurology
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

This Article
Right arrow Full Text (PDF)
Right arrow Correspondence:
Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Correspondence are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Dyck, P. J.
Right arrow Articles by Linscheid, R. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Dyck, P. J.
Right arrow Articles by Linscheid, R. L.
NEUROLOGY 1988;38:1586
© 1988 American Academy of Neurology

Assessment of nerve regeneration and adaptation after median nerve reconnection and digital neurovascular flap transfer

Peter James Dyck, MD, Edward H. Lambert, MD, PhD, Michael B. Wood, MD and Ronald L. Linscheid, MD

Peripheral Nerve Laboratory (Dr. Dyck) and Department of Orthopedics (Drs. Wood and Linscheid), Mayo Clinic and Mayo Foundation, Rochester, MN. Dr. Lambert is an emeritus member of the Department of Neurology, Mayo Clinic and Mayo Foundation.

Six patients with median nerve severance (five sutured) were studied after an interval of 1.8 to 35 years to assess residual neurologic deficit, misdirected axonal regrowth, and adaptation to faulty reinnervation. Mild motor impairment was confirmed by the smaller thenar muscle action potentials and isometric muscle twitches from supramaximal stimulation of the median nerve. Sensory impairment was supported by the increased thresholds of vibratory (p = 0.003) and touch-pressure (p –0.004) detection thresholds of the pulp of index fingers and decreased amplitudes of sensory nerve action potentials. A tactile hemidigit localization test revealed that localization was not significantly different from that on the contralateral side but perceptual territory was increased. This increase is best explained by misdirected axon regrowth without CNS adaptation. Longstanding faulty tactile digit localization in neurovascular skin flaps from finger to thumb also was demonstrated—further evidence that CNS adaptation is imperfect when sensory nerves to digits are relocated.

Address correspondence and reprint requests to Dr. Dyck, Mayo Clinic, 200 First Street SW, Rochester, MN 55905.

Received February 24, 1988. Accepted for publication in final form April 6, 1988.






HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1988 by AAN Enterprises, Inc.